Of Groopman, Misdiagnosis and Dr. Phil

Dr. Jerome Groopman holds a chair at Harvard Medical School, writes for the New Yorker Magazine, and has just published a book, How Doctors Think. I haven’t read it yet, but I’ve read at least a dozen reviews. What I most appreciate is that Dr. Groopman — a doctor held in high esteem by his peers, and uber-believeable by patients — may have created enough of an uproar that the medical profession may finally have to reckon with its malignancy — misdiagnosis.

Based on his own experience, where six different doctors gave Dr. Groopman four different diagnoses for a problem with his hand, Dr. Groopman acknowledges that doctors often do not listen to their patients, do NOT have “total knowledge”, are influenced by all kinds of factors that have nothing to do with the actual patient in front of them, make choices based on whether they like or don’t like a patient, and that they MISDIAGNOSE between 15 and 20 percent of the time.

Scary stuff. In a way — comforting. At least a relief of sorts. And perhaps a fresh start.

First — scary because that means 15 – 20% of patients are being treated incorrectly. Most will suffer. Some will die. Loss will be felt by patients, their families, and their pocketbooks.

Comforting — because it means that I’m not alone in my misdiagnosis odyssey. Groopman saw six doctors for four diagnoses. My story involved 13 doctors (including all the pathologists that reviewed my biopsy) and I got four different answers (or non-answers) too. And I’m not even convinced I ever did get the RIGHT answer.

A relief — because we can’t change what we don’t acknowledge (thank you Dr. Phil) — and this is acknowledgement by a highly regarded professional of a dirty little secret that has traditionally gone ignored. Groopman cites a study that shows doctors don’t listen. In fact, on average, they interrupt a patient within 18 seconds of asking “why are you here today?” Those doctors who still believe they have “total knowledge” (Groopman’s description) — in my experience, the majority of them — are going to find themselves confronting this reality — at last — or else.

And that’s where the fresh start comes in. Hopefully, in some ways, this will give those doctors the “permission” they need to see reality — and begin partnering with their patients instead of preaching to them. (And we all know what publicly happens to those preachers who pretend they are something they are not!)

Sharp patients will take Dr. Groopman’s best advice. Continually ask questions, and be a partner with your doctor. Ask questions like “What else can it be?” and “What other ways can it be treated?” and if you feel like you and your doctor aren’t communicating well? Then get another doctor.

We’ve all known it. Many just don’t want to believe it. Doctors are HUMAN, just like the rest of us. Or, as Grampa used to tell me, they all pull their pants on the same way the rest of us do.

Don’t let your health suffer because you’d rather believe doctors have “total knowledge.” We know FAR more about our own bodies than our doctors do. We just don’t have the right words to describe the problems, nor the education to determine what needs to be done to fix us. Getting the right answers requires BOTH our doctor’s expertise AND our own.